Provider Demographics
NPI:1538282132
Name:BERNSTEIN, BRUCE HARVEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:HARVEY
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 BLUNT RD
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-9064
Mailing Address - Country:US
Mailing Address - Phone:212-679-4440
Mailing Address - Fax:
Practice Address - Street 1:139 E 35TH ST
Practice Address - Street 2:APT. 6G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4176
Practice Address - Country:US
Practice Address - Phone:212-679-4440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4346103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical